Laparoscopic pyeloplasty in the infant younger than 6 months - Is it technically possible?

Purpose: Laparoscopic dismembered pyeloplasty is an acceptable option for UPJ obstruction in the pediatric population. We report our initial experience with this approach in infants. Materials and Methods: Eight infants 3 to 5 months old (mean 4.5) underwent transperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction. All patients underwent dismembered pyeloplasty with renal pelvis tapering. Two patients underwent concomitant pyelolithotomy and 1 underwent contralateral nephrectomy. Outcome measures included operative time, length of hospital stay, and resolution of obstruction by ultrasonography and DRI. Results: Mean operative time was 1.8 hours for the pyeloplasty portion. Mean hospital stay was 1.2 days. The stent was removed 6 weeks postoperatively in all patients except 1. This patient, 1 of the 2 patients who underwent concomitant pyelolithotomy, had development of a new stone while the stent was still indwelling. Laparoscopic pyeloplasty resulted in 100% resolution of UPJ obstruction in this series. Conclusions: We believe that laparoscopic dismembered pyeloplasty is technically possible in infants younger than 6 months.